Department of Ophthalmology, Calderdale Royal Hospital, Salterhebble, Halifax HX3 0PW, UK.
Br J Ophthalmol. 2012 Feb;96(2):185-8. doi: 10.1136/bjo.2010.201699. Epub 2011 May 17.
To compare the outcomes of non-posturing macular-hole surgery using sulfur hexafluoride (SF(6)) gas versus perfluoroethane (C(2)F(6)) for idiopathic macular hole repair. Design Interventional, comparative cohort study.
39 eyes of 38 patients undergoing macular-hole surgery with SF(6) were compared with another consecutive group of 39 eyes (39 patients) in whom C(2)F(6) was used. All patients were operated on by a single surgeon and underwent 23G transconjunctival phakovitrectomy with no prone posturing in the postoperative period. The best-corrected Snellen's visual acuity (VA) was converted to the logarithm of minimal angle of resolution (logmar) visual acuity for analysis. Optical coherence tomography documentation of anatomical closure and complications of surgery were recorded.
Primary hole closure was achieved in 89.75% in the C(2)F(6) group and 87.2% in the SF(6) group. Secondary closure after non-posturing redo surgery with heavy oil (Oxane-HD) was 100% in both groups. The mean preoperative VA in the C(2)F(6) group and SF(6) group was 0.81 logMAR and 0.78 respectively. 2 weeks after surgey, SF(6) was completely absorbed in all cases, and the mean VA improved to 0.5 logMAR; however, it remained 1.9 logMAR in the C(2)F(6) group. The final mean VA at 6 months was 0.44 (range 0-0.78) and 0.38 (range 0-1) in the C(2)F(6) and SF(6) group respectively. There were no instances of pupillary capture in the SF(6) group, whereas there were four in the C(2)F(6) group.
Macular-hole surgery with SF(6) gas achieves similar results to C(2)F(6) and is absorbed faster, allowing quicker visual rehabilitation for the patient.
比较非俯卧位下使用六氟化硫(SF(6))气体与全氟丙烷(C(2)F(6))治疗特发性黄斑裂孔的手术效果。设计:介入性、比较队列研究。
将 39 只眼(38 例)接受 SF(6)黄斑裂孔手术的患者与另一组连续的 39 只眼(39 例)患者进行比较,后者使用 C(2)F(6)。所有患者均由同一位外科医生进行 23G 经结膜无缝线玻璃体切除术,术后无需俯卧位。最佳矫正视力(VA)换算为最小分辨角对数(logmar)视力进行分析。记录光学相干断层扫描(OCT)记录的解剖闭合和手术并发症。
C(2)F(6)组和 SF(6)组原发性裂孔闭合率分别为 89.75%和 87.2%。两组均行非俯卧位重硅油(Oxane-HD)再手术,二次闭合率均为 100%。C(2)F(6)组和 SF(6)组术前平均 VA 分别为 0.81 logMAR 和 0.78。术后 2 周,SF(6)组所有病例均完全吸收,平均 VA 提高至 0.5 logMAR;然而,C(2)F(6)组仍为 1.9 logMAR。6 个月时的最终平均 VA 分别为 0.44(范围 0-0.78)和 0.38(范围 0-1),C(2)F(6)组和 SF(6)组分别为 0.44(范围 0-0.78)和 0.38(范围 0-1)。SF(6)组无瞳孔捕获,C(2)F(6)组有 4 例。
SF(6)气体黄斑裂孔手术效果与 C(2)F(6)相似,吸收更快,患者视力恢复更快。